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  • Question 1 - Compression of this nerve can cause weakness in the left leg while walking...

    Incorrect

    • Compression of this nerve can cause weakness in the left leg while walking and thigh adduction weakness at the hip joint.

      Your Answer: Sciatic nerve

      Correct Answer: Obturator nerve

      Explanation:

      The obturator nerve is a sensory and motor nerve that emerges from the lumbar plexus and innervates the thigh.

      This nerve supplies motor innervation to the medial compartment of the thigh, making it necessary for thigh adduction.

    • This question is part of the following fields:

      • Anatomy
      • Lower Limb
      12.6
      Seconds
  • Question 2 - In ventricular myocytes, the plateau phase of the action potential comes about through which...

    Incorrect

    • In ventricular myocytes, the plateau phase of the action potential comes about through which of the following:

      Your Answer: Opening of voltage-gated K + channels

      Correct Answer: Opening of voltage-gated Ca 2+ channels

      Explanation:

      After the intial upstroke of the action potential, Na+channels and currents rapidly inactivate, but in cardiac myocytes, the initial depolarisation activates voltage-gated Ca2+channels (slow L-type channels, threshold approximately – 45 mV) through which Ca2+floods into the cell. The resulting influx of Ca2+prevents the cell from repolarising and causes a plateau phase, that is maintained for about 250 ms until the L-type channels inactivate. The cardiac AP is thus much longer than that in nerve or skeletal muscle.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      16.2
      Seconds
  • Question 3 - A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part...

    Incorrect

    • A 33-year-old heavily muscled man presents with left-sided chest pain. After taking part in a powerlifting competition, he felt a painful snap at the front of his shoulder and chest. There is also the presence of bruising and swelling over the left side of his chest. A ruptured pectoralis major muscle was suspected upon examining the injured area.

      Which of the following statements regarding the surface markings of the pectoralis major muscle is considered correct?

      Your Answer:

      Correct Answer: It inserts into the lateral lip of the bicipital groove of the humerus

      Explanation:

      The pectoralis major is the superior most and largest muscle of the anterior chest wall. It is a thick, fan-shaped muscle that lies underneath the breast tissue and forms the anterior wall of the axilla.

      Its origin lies anterior surface of the medial half of the clavicle, the anterior surface of the sternum, the first 7 costal cartilages, the sternal end of the sixth rib, and the aponeurosis of the external oblique of the anterior abdominal wall.
      The insertion of the pectoralis major is at the lateral lip of the intertubercular sulcus of the humerus. There are 2 heads of the pectoralis major, the clavicular and the sternocostal, which reference their area of origin.
      The function of the pectoralis major is 3-fold and dependent on which heads of muscles are involved:
      – Flexion, adduction and medial rotation of the arm at the glenohumeral joint
      – Clavicular head causes flexion of the extended arm
      – Sternoclavicular head causes extension of the flexed arm

      Arterial supply of the pectoralis major, the pectoral artery, arises from the second branch of the axillary artery, the thoracoacromial trunk.

      The 2 heads of the pectoralis major have different nervous supplies. The clavicular head derives its nerve supply from the lateral pectoral nerve. The medial pectoral nerve innervates the sternocostal head. The lateral pectoral nerve arises directly from the lateral cord of the brachial plexus, and the medial pectoral nerve arises from the medial cord.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 4 - Which of the following statements about lithium treatment is FALSE: ...

    Incorrect

    • Which of the following statements about lithium treatment is FALSE:

      Your Answer:

      Correct Answer: Concomitant treatment with NSAIDs decreases serum-lithium concentration.

      Explanation:

      Lithium levels are raised by NSAIDs because renal clearance is reduced. Lithium is a small ion (74 Daltons) with no protein or tissue binding and is therefore amenable to haemodialysis. Lithium is freely distributed throughout total body water with a volume of distribution between 0.6 to 0.9 L/kg, although the volume may be smaller in the elderly, who have less lean body mass and less total body water. Steady-state serum levels are typically reached within five days at the usual oral dose of 1200 to 1800 mg/day. The half-life for lithium is approximately 18 hours in adults and 36 hours in the elderly.
      Lithium is excreted almost entirely by the kidneys and is handled in a manner similar to sodium. Lithium is freely filtered but over 60 percent is then reabsorbed by the proximal tubules.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 5 - Platelet alpha granules release which of the following? ...

    Incorrect

    • Platelet alpha granules release which of the following?

      Your Answer:

      Correct Answer: Von Willebrand factor (VWF)

      Explanation:

      There are three types of storage granules contained in platelets. These are dense granules which contain the following:
      -ATP
      -ADP
      -serotonin and calcium alpha granules containing clotting factors
      -von Willebrand factor (VWF)
      -platelet-derived growth factor (PDGF)
      – other proteins lysosomes containing hydrolytic enzymes.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds
  • Question 6 - What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:...

    Incorrect

    • What is the main mechanism of action of dobutamine as an inotropic sympathomimetic:

      Your Answer:

      Correct Answer: Beta1-receptor agonist

      Explanation:

      Dobutamine directly stimulates the beta1-adrenergic receptors in the heart and increases contractility and cardiac output with little effect on the rate. In addition action on beta2-receptors causes vasodilation.

    • This question is part of the following fields:

      • Cardiovascular
      • Pharmacology
      0
      Seconds
  • Question 7 - The ECG of a patient presenting with a history of intermittent palpitations has...

    Incorrect

    • The ECG of a patient presenting with a history of intermittent palpitations has a prolonged QT interval.

      Which of these can cause prolongation of the QT interval on the ECG?

      Your Answer:

      Correct Answer: Hypomagnesaemia

      Explanation:

      The causes of a prolonged QT interval include:

      Hypomagnesaemia
      Hypothermia
      Hypokalaemia
      Hypocalcaemia
      Hypothyroidism
      Jervell-Lange-Nielsen syndrome (autosomal dominant)
      Romano Ward syndrome (autosomal recessive)
      Ischaemic heart disease
      Mitral valve prolapse
      Rheumatic carditis
      Erythromycin
      Amiodarone
      Quinidine
      Tricyclic antidepressants
      Terfenadine
      Methadone
      Procainamide
      Sotalol

    • This question is part of the following fields:

      • Cardiovascular Physiology
      • Physiology
      0
      Seconds
  • Question 8 - Digoxin exhibits its positive inotropic effect by which of the following mechanisms: ...

    Incorrect

    • Digoxin exhibits its positive inotropic effect by which of the following mechanisms:

      Your Answer:

      Correct Answer: Inhibits the Na+/K+ pump on the myocyte membrane

      Explanation:

      Cardiac glycosides (e.g. digoxin) slow the removal of Ca2+from the cell by inhibiting the membrane Na+pump (Na+/K+ATPase) which generates the Na+gradient required for driving the export of Ca2+by Na+/Ca2+exchange; consequently the removal of Ca2+from the myocyte is slowed and more Ca2+is available for the next contraction.

    • This question is part of the following fields:

      • Cardiovascular
      • Physiology
      0
      Seconds
  • Question 9 - What is the main mechanism of action of metoclopramide: ...

    Incorrect

    • What is the main mechanism of action of metoclopramide:

      Your Answer:

      Correct Answer: Dopamine antagonist

      Explanation:

      Metoclopramide is a dopamine-receptor antagonist. Blockade of inhibitory dopamine receptors in the GI tract may allow stimulatory actions of ACh at muscarinic synapses to predominate. Metoclopramide also blocks dopamine D2-receptors within the chemoreceptor trigger zone (CTZ). At high doses, it is also thought to have some 5-HT3antagonist activity.

    • This question is part of the following fields:

      • Central Nervous System
      • Pharmacology
      0
      Seconds
  • Question 10 - An 18-year-old student presents with a 1-week history of sore throat, low grade...

    Incorrect

    • An 18-year-old student presents with a 1-week history of sore throat, low grade fever, and malaise. Upon history taking, she noted that she had a fine rash over her body a week ago that quickly fades. Further examination and observation was done and the presence of mild splenomegaly was noted. Her test shows positive for heterophile antibody test, suspecting a diagnosis of infectious mononucleosis.

      Which of the following characteristics is mostly associated with the diagnosis of infectious mononucleosis?

      Your Answer:

      Correct Answer: Atypical lymphocytes

      Explanation:

      Epstein-Barr virus causes infectious mononucleosis which is a clinical entity characterized by sore throat, cervical lymph node enlargement, fatigue and fever.

      It is accompanied by atypical large peripheral blood lymphocytes. These atypical lymphocytes, also known as Downey cells, are actually activated CD8 T lymphocytes, most of which are responding to EBV-infected cells.

    • This question is part of the following fields:

      • Microbiology
      • Specific Pathogen Groups
      0
      Seconds
  • Question 11 - The most common source of healthcare-associated bacteraemia is: ...

    Incorrect

    • The most common source of healthcare-associated bacteraemia is:

      Your Answer:

      Correct Answer: Intravenous cannula

      Explanation:

      Healthcare-associated bacteraemia is most commonly caused by intravenous access. Any intravenous device that is left in place for a long time increases the risk of infection. It allows bacteria like Staphylococcus aureus and Staphylococcus epidermidis to enter the body.

    • This question is part of the following fields:

      • Microbiology
      • Principles
      0
      Seconds
  • Question 12 - Which of the following accurately describes the extensor pollicis brevis muscle? ...

    Incorrect

    • Which of the following accurately describes the extensor pollicis brevis muscle?

      Your Answer:

      Correct Answer: It lies on the medial side of abductor pollicis longus

      Explanation:

      Extensor pollicis brevis is a short and slender muscle located in the posterior compartment of the forearm, extending from the posterior surface of radius to the proximal phalanx of thumb. It is one of the deep extensors of the forearm, together with supinator, abductor pollicis longus, extensor pollicis longus and extensor indicis muscles.

      Extensor pollicis brevis is a deep extensor of the thumb that lies deep to extensor digitorum muscle. It sits directly medial to abductor pollicis longus and posterolateral to extensor pollicis longus muscle. Just above the wrist, extensor pollicis brevis obliquely crosses the tendons of extensor carpi radialis brevis and extensor carpi radialis longus muscles.

      Extensor pollicis brevis is innervated by posterior interosseous nerve which is a continuation of a deep branch of radial nerve (root value C7 and C8).

      Extensor pollicis brevis receives its blood supply by posterior interosseous artery and perforating branches from the anterior interosseous artery, which are the branches of common interosseous artery. The common interosseous artery arises immediately below the tuberosity of radius from the ulnar artery.

      Together with extensor pollicis longus, extensor pollicis brevis is in charge of extension of the thumb in the first metacarpophalangeal joint. It also extends the thumb in the carpometacarpal joint of the thumb. This movement is important in the anatomy of the grip, as it enables letting go of an object. As it crosses the wrist, extensor pollicis brevis also participates in the extension and abduction of this joint.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 13 - What is the mechanism of action of cetirizine: ...

    Incorrect

    • What is the mechanism of action of cetirizine:

      Your Answer:

      Correct Answer: H1-receptor antagonist

      Explanation:

      Cetirizine is a competitive inhibitor at the H1-receptor (an antihistamine).

    • This question is part of the following fields:

      • Pharmacology
      • Respiratory
      0
      Seconds
  • Question 14 - Fatigue, dizziness upon standing, muscle weakness, weight loss, nausea, and sweating are all symptoms...

    Incorrect

    • Fatigue, dizziness upon standing, muscle weakness, weight loss, nausea, and sweating are all symptoms that a patient may experience in Addison's disease.

      Which of the following claims about Addison's disease is correct?

      Your Answer:

      Correct Answer: ACTH levels are elevated in primary insufficiency

      Explanation:

      The adrenal glands produce too little steroid hormones, which causes Addison’s disease. The production of glucocorticoids, mineralocorticoids, and sex steroids are all altered. The most prevalent cause is autoimmune adrenalitis, which accounts for 70-80 percent of cases.

      It affects more women than males and occurs most frequently between the ages of 30 and 50.

      The following are some of the clinical signs and symptoms of Addison’s disease:

      Weakness and sluggishness
      Hypotension is a condition in which the blood pressure (notably orthostatic hypotension)
      Vomiting and nausea
      Loss of weight
      Axillary and pubic hair loss
      Depression
      Hyperpigmentation is a condition in which a person’s (palmar creases, buccal mucosa and exposed areas more commonly affected)
      The following are the classic biochemical hallmarks of Addison’s disease:
      Hyponatraemia
      Hyperkalaemia
      Hypercalcaemia
      Hypoglycaemia
      Acidosis metabolica
      When ACTH levels are combined with cortisol levels, it is possible to distinguish between primary and secondary adrenal insufficiency:
      In primary insufficiency, levels rise.
      In secondary insufficiency, levels are low or low normal.

    • This question is part of the following fields:

      • Endocrine Physiology
      • Physiology
      0
      Seconds
  • Question 15 - Which of the following is NOT an effect of cytokine activity: ...

    Incorrect

    • Which of the following is NOT an effect of cytokine activity:

      Your Answer:

      Correct Answer: Opsonisation of bacteria for phagocytosis

      Explanation:

      Cytokines are a family of chemical messengers, secreted by leucocytes, that act over short distances by binding specific receptors on target cell surfaces. They include: interleukins (act between leucocytes), interferons (inhibit replication of viruses within cells and activate macrophages and natural killer cells), growth factors, and tumour necrosis factors (kill tumour cells). Effects include: induction of fever and acute phase response, stimulation of leucocyte differentiation and maturation, leucocyte recruitment and activation and increased antibody production.

    • This question is part of the following fields:

      • Inflammatory Responses
      • Pathology
      0
      Seconds
  • Question 16 - Regarding the brachioradialis muscle, which of the following statements is true? ...

    Incorrect

    • Regarding the brachioradialis muscle, which of the following statements is true?

      Your Answer:

      Correct Answer: It assists with supination of the forearm at the radioulnar joints

      Explanation:

      Brachioradialis is a fusiform muscle located in the lateral part of the posterior forearm. Along with extensor carpi radialis brevis and extensor carpi radialis longus, it comprises the radial group of forearm muscles, which belong to the superficial layer of posterior forearm muscles. Although anatomically part of the posterior forearm muscles, which are known to be forearm extensors, brachioradialis’ fibre orientation enables it to rather flex the forearm, and aids in supination of the forearm at the radioulnar joint.

      The brachioradialis muscle originates from the upper two-thirds of the lateral supracondylar ridge of humerus and the anterior surface of the lateral intermuscular septum of the arm. It slides over the lateral surface of the elbow joint, entering the anterolateral cubital area. The muscle fibres course inferiorly down the radial part of the anterior forearm, forming a thick tendon in approximately the middle of the forearm. This tendon then traverses the remainder of the forearm, inserting near the wrist, just proximal to the styloid process of radius.

      Brachioradialis is innervated by the radial nerve (from the root values C5-C6) that stems from the posterior cord of the brachial plexus. Blood supply to the brachioradialis muscle comes from branches of the radial artery, radial recurrent artery and the radial collateral branch of the deep brachial artery.

    • This question is part of the following fields:

      • Anatomy
      • Upper Limb
      0
      Seconds
  • Question 17 - What is the interquartile range of the following data set: 5, 10, 15,...

    Incorrect

    • What is the interquartile range of the following data set: 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 60, 70

      Your Answer:

      Correct Answer: 30

      Explanation:

      5, 10, 15 /20, 25, 30 /35, 40, 45 /50, 60, 70
      Sample size (n) = 12
      Median = [(n+1)/2]th value
      = (12+1)/2 = 6.5
      = halfway between 6th and 7th value
      = (30 +35)/2 = 32.5
      The lower (first) quartile = halfway between 15 and 20
      = 17.5
      The upper (third) quartile = halfway between 45 and 50
      = 47.5
      The interquartile range is the difference between the upper quartile and lower quartile
      = 47.5 – 17.5 = 30

    • This question is part of the following fields:

      • Evidence Based Medicine
      • Statistics
      0
      Seconds
  • Question 18 - Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that...

    Incorrect

    • Antinuclear antibodies (ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus.

      Which ONE of these statements about ANAs is true?

      Your Answer:

      Correct Answer: They can be of any immunoglobulin class

      Explanation:

      Anti-nuclear antibodies(ANAs) also referred to as anti-nuclear factors (ANFs) are autoantibodies that bind to contents of the cell nucleus. They can be of any immunoglobulin class.

      CREST syndrome is usually associated with anti-centromere antibodies.

      ELISA testing is cheaper but not the most accurate means of testing for ANAs. Indirect immunofluorescence testing is the most reliable.

      Nucleolar staining is suggestive of scleroderma, while homogenous staining is suggestive of lupus.

      Anti-dsDNA antibodies are found in 80 – 90% of patients with SLE

    • This question is part of the following fields:

      • General Pathology
      • Pathology
      0
      Seconds
  • Question 19 - Regarding basophils, which of the following statements is INCORRECT: ...

    Incorrect

    • Regarding basophils, which of the following statements is INCORRECT:

      Your Answer:

      Correct Answer: They are the second most common type of granulocyte.

      Explanation:

      Basophils are only occasionally seen in normal peripheral blood comprising < 1% of circulating white cells. However, they are the largest type of granulocyte. They have many dark cytoplasmic granules which overlie the nucleus and contain heparin and histamine. They have immunoglobulin E (IgE) attachment sites and their degranulation is associated with histamine release. Basophils are very similar in both appearance and function to mast cells.

    • This question is part of the following fields:

      • Immune Responses
      • Pathology
      0
      Seconds
  • Question 20 - You've been summoned to a young man in the resus area who has...

    Incorrect

    • You've been summoned to a young man in the resus area who has an SVT. You decide to use adenosine after trying several vagal manoeuvres without success.

      The use of adenosine is not contraindicated in which of the following situations?

      Your Answer:

      Correct Answer: Concurrent use of a beta-blocker

      Explanation:

      The use of a beta-blocker at the same time increases the risk of myocardial depression, but it is not a contraindication.
      The use of adenosine is contraindicated in the following situations:
      Asthma
      COPD (chronic obstructive pulmonary disease)
      Decompensated heart failure 
      Long QT syndrome
      AV block in the second or third degree
      Sinusitis is a condition in which the sinuses become (unless pacemaker fitted)
      Hypotension that is severe

    • This question is part of the following fields:

      • Cardiovascular Pharmacology
      • Pharmacology
      0
      Seconds
  • Question 21 - A 23-year-old male presents to his family physician with the complaint of repeated...

    Incorrect

    • A 23-year-old male presents to his family physician with the complaint of repeated episodes of abdominal pain and the passage of dark coloured urine every morning. He also reports increasing fatigue over the past several months. On examination, there are raised, painful red nodules over the skin of the back. Laboratory workup shows haemolytic anaemia, leukopenia and thrombocytopenia.

      Which one of the following disorders is this patient most likely to have?

      Your Answer:

      Correct Answer: Paroxysmal nocturnal haemoglobinuria

      Explanation:

      Paroxysmal nocturnal haemoglobinuria is an acquired genetic disorder that causes a decrease in red blood cells due to a membrane defect that allows increased complement binding to RBCs, causing haemolysis. Patients complain of dark-coloured urine first in the morning due to haemoglobinuria secondary to lysis of red blood cells overnight.

      Thrombosis occurs, which affects hepatic, abdominal, cerebral and subdermal veins. Thrombosis of hepatic veins can lead to Budd-Chiari syndrome, thrombosis of subdermal veins can lead to painful nodules on the skin, and thrombosis of cerebral vessels can lead to stroke. The presence of dark urine in the morning only and at no other time differentiates this condition from other conditions.

      Multiple myeloma would present with bone pain, signs of radiculopathy if there were nerve root compression and a history of repeated infections.

      Patients with Non-Hodgkin Lymphoma would complain of enlarged lymph nodes, fatigue, fever, weight loss and a history of repeated infections.

      Acute lymphoblastic leukaemia presents more commonly in children than in adults. The patient would complain of bone pain, and on examination, there would be hepatosplenomegaly.

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 22 - Which of the following statements is correct regarding gentamicin? ...

    Incorrect

    • Which of the following statements is correct regarding gentamicin?

      Your Answer:

      Correct Answer: Gentamicin is ineffective against anaerobic bacteria.

      Explanation:

      Gentamicin is the aminoglycoside of choice and is a parenterally administered, broad spectrum antibiotic typically used for moderate to severe gram negative infections. However, it is inactive against anaerobes. There is poor activity against haemolytic streptococci and pneumococci. It is usually given in conjunction with a penicillin or metronidazole (or both) when used for the blind treatment of undiagnosed serious infections. Nephrotoxicity and ototoxicity are the main toxic effects due to damage to the vestibulocochlear nerve (CN VIII).

      It is contraindicated in myasthenia gravis and should be used with great care in renal disease as it may result in accumulation and a higher risk of toxic side effects.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
      0
      Seconds
  • Question 23 - A 60-year-old female is referred to the Oncology clinic due to the presence...

    Incorrect

    • A 60-year-old female is referred to the Oncology clinic due to the presence of lumps in her neck. There is a non-tender enlargement of several groups of cervical lymph nodes on examination. She is sent for a lymph node biopsy. The results show the presence of lymphoma cells, but there are no Reed-Sternberg cells.

      Which one is most appropriate for this case out of the following diagnoses?

      Your Answer:

      Correct Answer: Non-Hodgkin’s lymphoma

      Explanation:

      Non-Hodgkin’s Lymphoma (NHL) causes neoplastic transformation of both B cell (85%) and T cell (15%) lines.

      The most common presentation is with enlarged, rubbery, painless lymph nodes. The patient may also have B symptoms which consist of night sweats, weight loss and fevers. Multiple myeloma most commonly presents with bone pain, especially in the back and ribs.

      The presence of Reed-Sternberg cells characterises Hodgkin’s lymphoma. Acute lymphoblastic leukaemia will present with features of anaemia, thrombocytopenia and leukopenia. The most common symptoms of chronic lymphocytic leukaemia are fatigue, night sweats and low-grade fever.

      The peak incidence of NHL is in the 50-70 years age group, it affects men and women equally, but affects the Caucasian population more commonly than black and Asian ethnic groups.
      The following are recognised risk factors for NHL:
      Chromosomal translocations and molecular rearrangements
      Epstein-Barr virus infection
      Human T-cell leukaemia virus type-1 (HTLV-1)
      Hepatitis C
      Congenital and acquired immunodeficiency states
      Autoimmune disorders, e.g. Sjogren’s syndrome and Hashimoto’s thyroiditis

    • This question is part of the following fields:

      • Haematology
      • Pathology
      0
      Seconds
  • Question 24 - Hartmann's solution contains how much sodium: ...

    Incorrect

    • Hartmann's solution contains how much sodium:

      Your Answer:

      Correct Answer: 131 mmol/L

      Explanation:

      Hartmann’s solution (compound sodium lactate) contains: Na+131 mmol/L, K+5 mmol/L, HCO3-29 mmol/L (as lactate), Cl-111 mmol/L, Ca2+2 mmol/L. It can be used instead of isotonic sodium chloride solution during or after surgery, or in the initial management of the injured or wounded; it may reduce the risk of hyperchloraemic acidosis.

    • This question is part of the following fields:

      • Fluids And Electrolytes
      • Pharmacology
      0
      Seconds
  • Question 25 - The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is...

    Incorrect

    • The syndrome of inappropriate antidiuresis due to excessive antidiuretic hormone (ADH) secretion is diagnosed in a male patient with a history of recurrent hyponatraemia.

      Which of the following produces ADH?

      Your Answer:

      Correct Answer: Hypothalamus

      Explanation:

      Antidiuretic hormone (ADH), commonly known as vasopressin, is a peptide hormone that controls how much water the body retains.

      It is produced in the magnocellular and parvocellular neurosecretory cells of the paraventricular nucleus and supraoptic nucleus in the hypothalamus from a prohormone precursor. It is subsequently carried to the posterior pituitary via axons and stored in vesicles.

      The secretion of ADH from the posterior pituitary is regulated by numerous mechanisms:
      Increased plasma osmolality: Osmoreceptors in the hypothalamus detect an increase in osmolality and trigger ADH release.

      Stretch receptors in the atrial walls and big veins detect a decrease in atrial pressure as a result of this (cardiopulmonary baroreceptors). ADH release is generally inhibited by atrial receptor firing, but when the atrial receptors are stretched, the firing reduces and ADH release is promoted.
      Hypotension causes baroreceptor firing to diminish, resulting in increased sympathetic activity and ADH release.
      An increase in angiotensin II stimulates angiotensin II receptors in the hypothalamus, causing ADH production to increase.

      The main sites of action for ADH are:
      The kidney is made up of two parts. ADH’s main job is to keep the extracellular fluid volume under control. It increases permeability to water by acting on the renal collecting ducts via V2 Receptors (via a camp-dependent mechanism). This leads to a decrease in urine production, an increase in blood volume, and an increase in arterial pressure as a result.

      Vascular system: Vasoconstriction is a secondary function of ADH. ADH causes vasoconstriction via binding to V1 Receptors on vascular smooth muscle (via the IP3 signal transduction pathway). An increase in arterial pressure occurs as a result of this.

    • This question is part of the following fields:

      • Physiology
      • Renal Physiology
      0
      Seconds
  • Question 26 - The correct statement regarding the parasympathetic nervous system is which of the following?...

    Incorrect

    • The correct statement regarding the parasympathetic nervous system is which of the following?

      Your Answer:

      Correct Answer: Parasympathetic preganglionic neurones run in cranial nerves III, VII, IX and X.

      Explanation:

      The electron transfer system is responsible for most of the energy produced during respiration. The is a system of hydrogen carriers located in the inner mitochondrial membrane. Hydrogen is transferred to the electron transfer system via the NADH2 molecules produced during glycolysis and the Krebs cycle. As a result, a H+ion gradient is generated across the inner membrane which drives ATP synthase. The final hydrogen acceptor is oxygen and the H+ions and O2 combine to form water.

    • This question is part of the following fields:

      • Basic Cellular
      • Physiology
      0
      Seconds
  • Question 27 - Which of the following is considered an example of an observational study? ...

    Incorrect

    • Which of the following is considered an example of an observational study?

      Your Answer:

      Correct Answer: Cohort study

      Explanation:

      The two most common types of observational studies are cohort studies and case-control studies; a third type is cross-sectional studies.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 28 - All of the following statements are considered true regarding likelihood ratios, except: ...

    Incorrect

    • All of the following statements are considered true regarding likelihood ratios, except:

      Your Answer:

      Correct Answer: If less than one, indicates that the information increases the likelihood of the suspected diagnosis

      Explanation:

      The Likelihood Ratio (LR) is the likelihood that a given test result would be expected in a patient with the target disorder compared to the likelihood that that same result would be expected in a patient without the target disorder.

      The LR is used to assess how good a diagnostic test is and to help in selecting an appropriate diagnostic tests or sequence of tests. They have advantages over sensitivity and specificity because they are less likely to change with the prevalence of the disorder, they can be calculated for several levels of the symptom/sign or test, they can be used to combine the results of multiple diagnostic test and they can be used to calculate post-test probability for a target disorder.

      A LR greater than 1 produces a post-test probability which is higher than the pre-test probability. An LR less than 1 produces a post-test probability which is lower than the pre-test probability. When the pre-test probability lies between 30 and 70 per cent, test results with a very high LR (say, above 10) rule in disease. An LR below 1 produces a post-test probability les than the pre-test probability. A very low LR (say, below 0.1) virtually rules out the chance that the patient has the disease.

    • This question is part of the following fields:

      • Evidence Based Medicine
      0
      Seconds
  • Question 29 - Which of the following statements is correct regarding the partial pressure of oxygen...

    Incorrect

    • Which of the following statements is correct regarding the partial pressure of oxygen during respiration?

      Your Answer:

      Correct Answer: Exhaled PO 2 > Alveolar PO 2

      Explanation:

      Because of humidification, inspired PO2 in the airways is less than inhaled PO2.
      Because of gas exchange, alveolar PO2 is less than inhaled or inspired PO2.
      Because of mixing with anatomical dead space (air that has not taken part in gas exchange, exhaled PO2 is greater than alveolar O2, and therefore that has relatively higher PO2 on the way out, but is less than inhaled or inspired PO2.
      Typical values for a resting young healthy male (in kPa) are shown below:
      -Inhaled air: PO221.2, PCO20.0
      -Inspired air in airways (after humidification): PO219.9, PCO20.0
      -Alveolar air (after equilibrium with pulmonary capillaries): PO213.3, PCO25.3
      -Exhaled air (after mixing with anatomical dead space air): PO215.5, PCO24.3

    • This question is part of the following fields:

      • Physiology
      • Respiratory
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  • Question 30 - Regarding penicillin antibiotics, which of the following statements is CORRECT: ...

    Incorrect

    • Regarding penicillin antibiotics, which of the following statements is CORRECT:

      Your Answer:

      Correct Answer: Patients with a history of atopy are at higher risk of hypersensitivity reactions.

      Explanation:

      Allergic reactions to penicillins occur in 1 – 10% of exposed individuals; anaphylactic reactions occur in fewer than 0.05% of treated patients. Patients with a history of atopic allergy are at higher risk of anaphylactic reactions to penicillins. Patients with a history of anaphylaxis, urticaria, or rash immediately after penicillin use should not receive a penicillin or other beta-lactam antibiotics; about 0.5 – 6.5 % of penicillin-sensitive patients will also be allergic to the cephalosporins.

      Patients with a history of a more minor rash (i.e. non-confluent, non-pruritic rash restricted to a small area of the body) or delayed reaction (rash occurring more than 72 hours after penicillin administration), may not be truly allergic and may be considered for penicillin or beta-lactam treatment in severe infection (although possibility of allergy should be borne in mind). Other beta-lactam antibiotics (including cephalosporins) can be used in these patients.

    • This question is part of the following fields:

      • Infections
      • Pharmacology
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